"We can only try our best."

Zhao Heng thought for a moment and said.

A penetrating head injury combined with a brainstem glial tumor; there isn't a single doctor in the world who can say they are absolutely confident in the anesthesia for this type of surgery.

"Some intraoperative procedures might still need your cooperation, junior. This time, it's really going to be hard on you."

Liu Ziang said.

Zhao Heng has an extremely high level of proficiency in neurosurgery, something he demonstrated in previous surgeries.

And this time, in addition to safely removing the steel bar penetrating the head and repairing the damaged tissue, they also need to perform an operation to remove the brainstem glial tumor. In Liu Ziang's view, only Zhao Heng has the skill level to assist him.

The most crucial thing is that for this patient, if they don't take this opportunity now to remove the brainstem tumor, even successfully removing the steel bar from the head, the patient might survive the surgery, but with the tumor's progression, the patient won't have more than three months to live.

"It's okay."

Zhao Heng said indifferently.

If he wanted an easy job, he wouldn't have chosen to be a doctor.

One hour later.

In the operating room.

For this surgery, Zhao Heng is in charge of anesthesia, the scrub nurse is Tian Zhen, the circulating nurse is Sun Li, and Liu Ziang is operating with two resident doctors.

At the workstation, Tian Zhen is preparing for the surgery while Liu Ziang is reviewing the brain CT scans.

Meanwhile, Zhao Heng and Sun Li are preparing the preoperative anesthesia.

"Dr. Zhao, what intravenous anesthetic should we use this time?"

Sun Li looked at the contemplative Zhao Heng and asked him.

Head trauma is not uncommon in neurosurgery, but such an injury where a steel bar directly penetrates the head is something even Sun Li, who has assisted in numerous neurosurgeries, is seeing for the first time.

Therefore, she knows very well the level of proficiency required to handle the anesthesia for this surgery.

"Propofol and remifentanil, I think."

Zhao Heng thought for a moment and replied.

Propofol is called the "cross-century" new anesthetic because of its rapid onset, fast metabolism, and lack of accumulation with continuous use, which makes it ideal for the target-controlled infusion technology (TCI) needed for this patient.

Remifentanil is a new pure μ-receptor agonist, likewise featuring rapid clearance and low side effects.

The patient's condition is already very unstable, so the anesthesia must minimize interference with the patient's physiological functions.

"Alright."

Sun Li nodded. The anesthetics Zhao Heng mentioned are basically all new types.

Most anesthesiologists are still using older anesthetics, lacking confidence in using new ones like propofol and remifentanil, especially on such complex cases.

Then, Sun Li quickly prepared the intravenous anesthetics, and once they were infused into the bloodstream, the patient entered a state of deep anesthesia.

However, Zhao Heng's heart was still tightly clenched.

Ten minutes later.

Zhao Heng checked the blood pressure and heart rate on the life monitor and said to Liu Ziang, "Senior, you can start the surgery now."

"Alright, good."

Liu Ziang nodded.

With Zhao Heng there, he felt reassured.

It's a peculiar feeling, as a genius in neurosurgery, it has always been that when he's present, others felt assured.

And now, the strong technical support Zhao Heng is providing gives him that feeling of assurance.

Liu Ziang composed himself and began the surgery with the two resident doctors; although he is an expert in neurosurgery, this operation is also very challenging for him.

The barbed steel rod is now lodged in the patient's skull. Removing it quickly while minimizing damage to the patient's brain tissue is a top priority.

During this process, every step must be performed with utmost care, as if walking on thin ice.

This requires an extremely high level of concentration and steady hands.

Frankly speaking, the two resident doctors working with Liu Ziang can only act as assistants; the most critical fine operations must be completed by Liu Ziang himself.

As time passed, although difficult, after two hours the steel bar lodged in the skull was finally removed intact by Liu Ziang.

Next comes the most difficult part: removing the glial tumor on the brainstem.

This surgery is almost one of the toughest in neurosurgical procedures.

On one hand, the brainstem controls human heart rate and breathing. If damaged during surgery, the patient's breathing and heart rate will stop immediately. Basically, once the surgery goes awry, the patient is very likely to die immediately.

This truly means life and death in an instant.

On the other hand, the process of removing the glial tumor is incredibly challenging.

To illustrate, an infiltrative glial tumor growing in brain tissue is like cauliflower growing inside tofu. Removing the cauliflower piece by piece without damaging the tofu at all is the most challenging part.

Afterward, Tian Zhen needs to prepare the instruments for the brainstem tumor removal, which takes some time.

Liu Ziang took this rare opportunity to sit beside Zhao Heng to rest and discuss the surgical details.

"Junior, what are your thoughts on the upcoming surgery?"

Sitting beside Zhao Heng, Liu Ziang inquired.

Usually, others come to him for questions, but only Zhao Heng can earn his respect, hence he values Zhao Heng's opinion highly.

"The patient's condition is extremely unstable; the surgery must be completed quickly, as conventional dissection is too slow."

Zhao Heng thought for a moment and said.

"What do you mean?"

Upon hearing Zhao Heng's words, Liu Ziang immediately nodded. This was also his concern; traditional brain tissue tumor resection takes too long and is unsuitable for this patient.

The surgery must end as swiftly as possible to prevent unforeseen complications. If the surgery drags on, the patient's likelihood of complications, such as respiratory and cardiac arrest, is nearly one hundred percent.

"We can use the removal technique designed for soft tumors, using the N-Yag laser to cauterize the tumor tissue before aspirating it."

Zhao Heng slowly expressed his thoughts.

This idea was formulated by combining neurosurgical experience gathered from working with Liu Ziang and experience from surgeries in other disciplines.

"N-Yag laser? We have the equipment, but we've never used it for brainstem tumor removal before..."

Hearing Zhao Heng's words, Liu Ziang's eyes lit up, and he fell into contemplation, murmuring.

The YAG laser has high gain, low threshold, high quantum efficiency, and low thermal effects, boasting minimal trauma and good healing when applied in medicine.

"While YAG lasers are typically used in dermatology, cosmetics, and ophthalmology, I believe they're suitable for removing soft brainstem glial tumors."

Zhao Heng added.

"Mm, indeed. Junior, you've given me another surprise."

Upon hearing Zhao Heng's words, Liu Ziang nodded repeatedly.

The laser removal method proposed by Zhao Heng hadn't occurred to even him.

Upon considering it, laser removal not only minimizes damage but also significantly shortens the surgery time.

It's just that no one had thought of applying lasers in such a critical area as the brainstem before.

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